12.6.16 Li2L Registration

This is the registration form for the December 6, 2016 12-1pm ET webinar:

"Structural Factors and Sexual Orientation Health Disparities in Adolescent Substance Use: A Multi-level Analysis" presented by Melanie “Somjen” Frazer, PhD Student, ABD in Sociomedical Sciences, Columbia University Mailman School of Public Health

1. First Name *This question is required.

2. Last Name *This question is required.

3. Email Address *This question is required.

4. Job Title *This question is required.

5. Organization *This question is required.

6. Which is the U.S. state/ territory/ commonwealth where you work? *This question is required.

7. Please select your employment setting (check all that apply) *This question is required.

Primary Care
Medically Underserved Community
Rural Area
None of the above

8. Please select your primary profession/discipline. *This question is required.

9. How confident are you that you can... *This question is required.

Space Cell	Not at all confident	Somewhat confident	Moderately confident	Very confident
Explain why it is important to understand structural causes of health disparities among sexual minority youth.	Explain why it is important to understand structural causes of health disparities among sexual minority youth. : Not at all confident	Explain why it is important to understand structural causes of health disparities among sexual minority youth. : Somewhat confident	Explain why it is important to understand structural causes of health disparities among sexual minority youth. : Moderately confident	Explain why it is important to understand structural causes of health disparities among sexual minority youth. : Very confident
Describe why substance use disparities might be a large and persistent cause of disparate morbidity among sexual minority youth.	Describe why substance use disparities might be a large and persistent cause of disparate morbidity among sexual minority youth. : Not at all confident	Describe why substance use disparities might be a large and persistent cause of disparate morbidity among sexual minority youth. : Somewhat confident	Describe why substance use disparities might be a large and persistent cause of disparate morbidity among sexual minority youth. : Moderately confident	Describe why substance use disparities might be a large and persistent cause of disparate morbidity among sexual minority youth. : Very confident
List potential outcomes to expect for sexual orientation substance use disparities among youth given the changing political landscape.	List potential outcomes to expect for sexual orientation substance use disparities among youth given the changing political landscape. : Not at all confident	List potential outcomes to expect for sexual orientation substance use disparities among youth given the changing political landscape. : Somewhat confident	List potential outcomes to expect for sexual orientation substance use disparities among youth given the changing political landscape. : Moderately confident	List potential outcomes to expect for sexual orientation substance use disparities among youth given the changing political landscape. : Very confident

10. Please select the reason you are attending this training (please select all that apply) *This question is required.

to learn more about the specific training topic
the training topic relates to my work
general interest in staying informed about public health practice
general interest in staying informed about current public health research
general interest in staying informed about public health policy
to obtain continuing education credits
Other (please specify) Please enter an 'other' value for this selection. * This question is required.